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High complication rate, superior HRQoL outcomes seen after surgical treatment of adult spinal deformity
According to results, patients with adult spinal deformity who were treated surgically compared with those who underwent nonoperative treatment had a high incidence of complications but achieved a clinically significant and relevant improvement in health-related quality of life.
Researchers identified 90 patients who were older than 70 years with adult spinal deformity. Of these patients, 61 patients underwent surgery and 29 patients underwent nonoperative treatment. All patients who underwent surgery were treated with posterior surgery. Before and after the treatment, investigators evaluated patient demographics, clinical, surgical and radiological characteristics, health-related quality of life (HRQoL), Oswestry Disability Index (ODI), SF-36 mental component (MCS) and physical component summary (PCS) and Scoliosis Research Society-22 (SRS-22) parameters.
Results showed that at baseline, the comparison between patients who underwent surgery and those who underwent nonoperative treatment was statistically significant for all HRQoL parameters and the major coronal Cobb angle. The calculated optimal value to diverge operative and nonoperative groups for the core outcome measures index was 5.7, for the ODI was 37, for the SF-36 PCS was 37.5 and for the SRS-22 was 3.2. Investigators noted 135 complications and one death.
Patients who underwent surgery improved clinically and in HRQoL parameters 2 years postoperatively for all HRQoL parameters apart from the SF-36 MSC, even with complications. However, at the end of 2 years, results for nonoperative patients did not change or deteriorate. – by Monica Jaramillo
Disclosures: The authors report no relevant financial disclosures.
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